Successful delayed aortic surgery for a patient with ischemic stroke secondary to aortic dissection

Ryuta Morihara; Toru Yamashita; Kentaro Deguchi; Keiichiro Tsunoda; Yasuhiro Manabe; Yoshiaki Takahashi; Taijun Yunoki; Kota Sato; Yumiko Nakano; Syoichiro Kono; Yasuyuki Ohta; Nozomi Hishikawa; Koji Abe

doi:10.2169/internalmedicine.8438-16

Successful delayed aortic surgery for a patient with ischemic stroke secondary to aortic dissection

Ryuta Morihara, Toru Yamashita, Kentaro Deguchi, Keiichiro Tsunoda, Yasuhiro Manabe, Yoshiaki Takahashi, Taijun Yunoki, Kota Sato, Yumiko Nakano, Syoichiro Kono, Yasuyuki Ohta, Nozomi Hishikawa, Koji Abe

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transformation. The patient successfully underwent aortic surgery on day 5 and was discharged with a remarkable improvement in his symptoms. Delayed surgery may avoid hemorrhagic transformation in patients with AD-induced IS who have received tPA.

Original language	English
Pages (from-to)	2343-2346
Number of pages	4
Journal	Internal Medicine
Volume	56
Issue number	17
DOIs	https://doi.org/10.2169/internalmedicine.8438-16
Publication status	Published - 2017

Keywords

Aortic dissection
Hemorrhagic transformation
Ischemic stroke
Recombinant tissue plasminogen activator

ASJC Scopus subject areas

Internal Medicine

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10.2169/internalmedicine.8438-16

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title = "Successful delayed aortic surgery for a patient with ischemic stroke secondary to aortic dissection",

abstract = "The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transformation. The patient successfully underwent aortic surgery on day 5 and was discharged with a remarkable improvement in his symptoms. Delayed surgery may avoid hemorrhagic transformation in patients with AD-induced IS who have received tPA.",

keywords = "Aortic dissection, Hemorrhagic transformation, Ischemic stroke, Recombinant tissue plasminogen activator",

author = "Ryuta Morihara and Toru Yamashita and Kentaro Deguchi and Keiichiro Tsunoda and Yasuhiro Manabe and Yoshiaki Takahashi and Taijun Yunoki and Kota Sato and Yumiko Nakano and Syoichiro Kono and Yasuyuki Ohta and Nozomi Hishikawa and Koji Abe",

note = "Funding Information: This work was supported in part by Grants-in-Aid for Scientific Research (B) 2529320216 and (C) 24591263; a Grant-in-Aid for Challenging Research 24659651 from the Ministry of Education, Culture, Sports, Science, and Technology; and by Grants-in-Aid from the Research Committees (H. Mizusawa, I. Nakano, M. Nishizawa, H. Sasaki, and M. Aoki) from the Ministry of Health, Labor, and Welfare of Japan. Publisher Copyright: {\textcopyright} 2017 The Japanese Society of Internal Medicine.",

year = "2017",

doi = "10.2169/internalmedicine.8438-16",

language = "English",

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AU - Morihara, Ryuta

AU - Yamashita, Toru

AU - Deguchi, Kentaro

AU - Tsunoda, Keiichiro

AU - Manabe, Yasuhiro

AU - Takahashi, Yoshiaki

AU - Yunoki, Taijun

AU - Sato, Kota

AU - Nakano, Yumiko

AU - Kono, Syoichiro

AU - Ohta, Yasuyuki

AU - Hishikawa, Nozomi

AU - Abe, Koji

N1 - Funding Information: This work was supported in part by Grants-in-Aid for Scientific Research (B) 2529320216 and (C) 24591263; a Grant-in-Aid for Challenging Research 24659651 from the Ministry of Education, Culture, Sports, Science, and Technology; and by Grants-in-Aid from the Research Committees (H. Mizusawa, I. Nakano, M. Nishizawa, H. Sasaki, and M. Aoki) from the Ministry of Health, Labor, and Welfare of Japan. Publisher Copyright: © 2017 The Japanese Society of Internal Medicine.

PY - 2017

Y1 - 2017

N2 - The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transformation. The patient successfully underwent aortic surgery on day 5 and was discharged with a remarkable improvement in his symptoms. Delayed surgery may avoid hemorrhagic transformation in patients with AD-induced IS who have received tPA.

AB - The diagnosis of aortic dissection (AD) is sometimes difficult within the limited time window of recombinant tissue plasminogen activator (tPA) for ischemic stroke (IS). A 60-year-old man developed sudden left hemiparesis due to IS. During tPA infusion, his blood pressure dropped and consciousness declined. After transfer to our hospital, carotid duplex ultrasonography led to a diagnosis of AD. Emergency surgery was postponed because of the risk of hemorrhagic transformation. The patient successfully underwent aortic surgery on day 5 and was discharged with a remarkable improvement in his symptoms. Delayed surgery may avoid hemorrhagic transformation in patients with AD-induced IS who have received tPA.

KW - Aortic dissection

KW - Hemorrhagic transformation

KW - Ischemic stroke

KW - Recombinant tissue plasminogen activator

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Successful delayed aortic surgery for a patient with ischemic stroke secondary to aortic dissection

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